Methotrexate

[Water-gem]

Hi, I’ve recently been diagnosed with RA and I’m about to start methotrexate. I would appreciate some help in deciding to take orally or by injection.

Many thanks.

[AgedCrone]

See how you go on the pills... I took Mtx pills up to 25mg for seven years no problems.... much more convenient than all the paraphernalia of injections.... even with the pen now used...especially if we ever get to go on holiday again!

[Water-gem in reply to AgedCrone]

Oh thank you for replying. I will start out with the pills. I’m also on sulphasalazine and they make me quite nauseous. Sick of feeling sick x

[Jillyanne in reply to Water-gem]

The good thing about the injections , apparently is that mtx by passes the stomach , so if the pills make you feel sick , the injections shouldn’t 🤔🤔

[Hoffster1984]

I have been taking the pills since 2016 and no side affects at all - doing really well!

[Water-gem in reply to Hoffster1984]

Oh good, really glad your well on them. I hear so many horror stories, I’m a bit scared of feeling worse than I do now. Thanks for your reply.

[KittyJ]

Agree with AC, I’d start on the pills and see how you go. I’ve been on them for 20+ years.

[Boxerlady]

Agree with the others - start on the tablets. Apart from anything else, it's easy to adjust the dose whereas with the injections, you need to wait for them to prescribe the new dose. Also, in my area (although it varies) the tablets can be prescribed by the GP under shared care and supplied by the local chemist whereas the injections have to be prescribed by the hospital clinic and collected/delivered from there.

[Water-gem]

That’s a very good point. Thank you for your reply.

[Summerrain14]

Hi Water-gem. So sorry you have recently been diagnosed with RA. We are a very friendly bunch. I started on MTX in August. Wanted to start with the tablets which I did. Been on them for two months now but had developed some side effects with bad sickness and upset stomach. I was okay for a few weeks and wanted to give the tablets a good try. Having shared care with my GP and rheumy team my GP was able to prescribe my MTX. Just about to start the injections as the upset stomach and sickness got the better of me with five days wiped out with it. The injections are prescribed by my hospital team and delivered to me via a home care service. I took delivery of a big box yesterday. The specialist nurse from the home care delivery service is coming to do my first training session on Monday all being well. I am so pleased to have given the tablets a good try for a couple of a months and if I had little side effects I would have happily stuck with them. Hopefully the injections will have less side effects for me as I can see a little improvement already with my RA with the MTX. Hope this helps a little.

[nomoreheels]

I agree with others, tablets first, for no other reason really that the dose is adjusted easily if you need an increase or reduction in dose. I took tablets for the first year & only changed to injections when I needed an increase in dose.

My GP signed a shared care agreement but unlike Boxerlady's does prescribe injections, filled by my allocated pharmacy. You're fortunate to be offered the choice, rarely done. I hope you find they make all the difference. Sorry though that SSZ is making you nauseous. Have you tried all the usual remedies, ginger etc, or been prescribed an anti emetic? It can be misery making & worse as it's a daily tablet causing it.

[Hidden]

I've been taking the pills for 19 months in doses up to 25mg. I've had no problems apart from having to stop for 3 weeks because of "deranged"(!) liver function test results. After the break things went back to normal. I'd much rather have pills than injections. They are more convenient, don't need special storage, easier to take on holiday (when, oh when?) and the dose can be adjusted really easily. So I'd say give them a go. They are also cheaper for the NHS but you can change to injections later if they don't suit you.

[Gand]

Start with the pills, I’ve been taking them for 10 years no side effects. If they bother you then try injection 😀

[BoneyC]

Go for it! I've had RA a lifetime (50 years) and taken MTX for about 40 years. It's been the best drug for me and I've tried lots.

[MJSlide1958 in reply to BoneyC]

Wow what a record! MTX for 40 years, you should be awarded a medal, that is brilliant. Are you on any other meds too for RA?

[BoneyC in reply to MJSlide1958]

... HCQ, Naproxen, Codeine, Folic Acid.

[Buckybri]

I was on the pills and it was the worst time of my life I was so ill that I’d rather of took the chance not to take them . Then I was put in the injection and now don’t even know that I have taken it . But we are not all the same I’m a big strong fit man and I really thought my body would cope with the pills but it made me so ill and depressed . I’d say go with the injection it’s easy and painless and don’t get ingested through the gut like oral meds .

[Pitbull2017]

Recently been diagnosed with RA and going straight onto MTX, times have changed it was the norm to go on painkillers anti inflametries and steroids for a number of years and then MTX and eventually biologicals.